Excerpt from Anne Fadimans- The Spirit Catches You and You Fall Down

Lia Lee was born on July 19, 1982 as the 14th child of Foua and Nao Kao, Hmong
immigrants now residing in Merced, California. All but one of their other children had been
born in Laos, where the birthing traditions were very different than in the United States. Foua
delivered each child with her own hands, without a birth attendant, keeping silent to avoid
thwarting the birth with noise. She then washed each baby with water she had carried from the
stream. Her husband helped by bringing her hot water to drink if she needed it, cutting the
umbilical cord, and tying it with string. He also buried the placenta, under the bed if the baby
was a girl and near the base of the central pillar of the house if it were a boy. The Hmong
believe that a person's soul travels back from place to place until it reaches the placenta, which
it must put on like a jacket in order to continue its journey to the place where it reunites with
its ancestors and will someday be reborn. Without the placenta, the soul is condemned to
wander for all time.
Lia's birth was very different. She was born in the Merced Community Medical Center in
California's Central Valley, where the Lees have relocated, along with many other Hmong
forced to leave their country after the communist takeover in 1975. Lia's placenta was
incinerated, as doctors generally fear that allowing the Hmong to take the placenta home may
result in its consumption by mothers or in the possible spread of hepatitis B, and in any case,
nobody at the birth spoke English. Foua gave birth on a steel table, unaccompanied by family
members, her amniotic sac artificially ruptured to speed the birth. Lia weighed 8 pounds 7
ounces and was a healthy child. She was taken to the central nursery to receive an injection of
Vitamin K and two drops of silver nitrate solution in each eye, and to be bathed with soap.
Foua found the birth experience peculiar, but she had few complaints. She was
impressed by the number of people there to help her and was concerned only with the food.
She was surprised to be offered ice water, since the Hmong believe cold foods after giving birth
make the blood congeal in the womb, and that consumption of such foods will make a woman
have itchy skin or diarrhea in old age. Foua accepted only what she calls "hot black water" from
the hospital and otherwise ate the Hmong foods prepared for her by her husband, Nao Kao.
The doctors were used to this diet, some noting its fragrant aroma and others complaining of its
stink, the comments reflecting their general opinions of the Hmong.
When Lia Lee was released from MCMC, at the age of three days, her mother was asked
to sign a piece of paper that read:
I CERTIFY that during the discharge procedure I received my baby, examined it and determined
that it was mine. I checked the Ident-A-Band parts sealed on the baby and on me and found
that they were identically numbered 5043 and contained correct identifying information.
Since Foua cannot read and has never learned to recognize Arabic numerals, it is unlikely that
she followed these instructions. However, she had been asked for her signature so often in the
United States that she had mastered the capital forms of the seven different letters contained
in her name, Foua Yang.